Pulmonary hypertension

Question 1

Causes of pulmonary HTN based on WHO classification

Answer 1

1. Pulmonary arterial HTN:
   
   • Narrowing of vessels in lungs
   • Causes fibrosis and cor pulmonale
2. Due to left heart disease:
   
   • Backlog of blood into lungs
   • Causes pulmonary oedema and pleural effusion
3. Due to lung diseases/hypoxia:
   
   • Hypoxic pulmonary vasoconstriction due to inadequate arterial oxygenation (e.g. COPD, interstitial lung disease, OSA)
4. Chronic thromboembolic HTN:
   
   • Vasoconstriction due to blockage of vessels by recurrent emboli

Question 2

Symptoms of pulmonary HTN

Answer 2

(SAD FAC):

• Syncope
• Angina
• Dyspnoea
• Fatigue
• Anorexia
• Cough

Question 3

Signs of pulmonary HTN

Answer 3

• Split S2
• Loud P2
• Tricuspid regurgitation
• Signs of right heart failure